The marketplaces' failures to attract a robust group of
health plans to many areas suggests that Obamacare’s insurance expansion
is on the path to looking like other safety net programs we know,
offering limited services to a predominantly low-income population.

"The exchange population — 85 percent of which qualifies
for financial assistance — looks a lot like the Medicaid population,"
says Michael Adelberg, who previously served as the administration’s
acting director of the exchange policy. "And with it, we’re seeing the
start of the ‘Medicaid-ization’ of exchange plans: narrow networks with
no frills."

Which is largely to say, the Medicaid expansion has been a "success", to the extent it has signed new people eligible under the new guidelines. However,

All available evidence suggests that the law is helping these people
gain access to medical services that were previously out of reach — and
there isn’t much reason to think this will change. Even when there are
large premium spikes, more than 80 percent of marketplace enrollees have
subsidies that ensure their monthly fees remain affordable.

The second point is the more important one, because if the number of providers goes to zero, the subsidy will not matter. This elemental fact is apparently lost on her. Kliff is likewise completely baffled by the bureaucratic monster she otherwise endorses (emboldening mine, as usual):

It is the considerable burden our fragmented system puts on patients to coordinate their own care.

I'm not talking about the work of managing one's health, the work
that diabetics do to monitor their blood sugar or the healthy eating
choices a doctor might recommend for an overweight patient. This can be a
significant burden in its own right.

What I didn't understand was the burden patients face in managing the health care system:
a massive web of doctors, insurers, pharmacies, and other siloed actors
that seem intent on not talking with one another. That unenviable task
gets left to the patient, the secret glue that holds the system
together.

Kliff naively believes that a cobbled-together system of shreds and patches and bureaucratic fumbling will do otherwise, especially when the payer is some combination of state and private entities. In that case, the most important person in this equation is always the payer, with the beneficiary coming in second, -ish. "Glue" is what we do to unfortunate race horses.

Update: Comes this Vox podcast starting Matt Yglesias, Ezra Klein, and Sarah Kliff in which they gabble on about how Obamacare isn't failing somehow (h/t Catherine Siena). The chirpy, twee tone about collapsing numbers of providers (and, what they don't mention, rising costs) reminds me of teenagers who broke a window without getting caught. No remorse, no apologies, no regrets; their earnest intentions, apparently, are enough.